Elsevier

Eating Behaviors

Volume 10, Issue 1, January 2009, Pages 16-21
Eating Behaviors

Body attitudes in patients with eating disorders at presentation and completion of intensive outpatient day treatment

https://doi.org/10.1016/j.eatbeh.2008.10.002Get rights and content

Abstract

Due to the importance of the distorted body experience in eating disorder diagnosis and treatment, we wanted to explore body attitudes of patients with eating disorders before and after 5 months of intensive specialized outpatient day treatment. We assessed 193 patients diagnosed with Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Eating Disorder Not Otherwise Specified (EDNOS) using the Body Attitude Test (BAT), Body Mass Index (BMI), Eating Disorder Evaluation Scale (EDES) and Symptom Checklist 90 (SCL-90). Eating disorder subtypes differed in BMI, total body attitudes and negative appreciation of body size at intake, but not at termination of treatment. Following treatment, all patient groups reported large improvements in eating disorder pathology and all but the AN-Restrictive (AN-R) group, reported large improvements in overall psychological functioning. The AN patients demonstrated significant improvement in BMI, however the Anorexia Nervosa purging (AN-P) and Anorexia Nervosa restrictive (AN-R) subtypes differed in their changes in body attitudes. AN-R patients indicated no significant improvement in body attitudes. AN-P patients improved in total body attitudes, except one subscale. Patients with Bulimia Nervosa non-purging (BN-NP) subtype, Bulimia Nervosa purging (BN-P) subtype and EDNOS demonstrated similar improvements in total body attitudes (BAT). Body attitudes provide important insights into differences between eating disorder diagnostic categories and their treatment responsiveness.

Section snippets

Treatment

All patients enrolled in the intensive outpatient day program of Amarum, a specialist center for the treatment of eating disorders located in Zutphen, The Netherlands. Patients attended group therapy 5 days a week and commit to a minimum stay of 26 weeks. The average length of treatment was 26 weeks. The treatment program at Amarum is multidimensional in nature, based on a biopsychosocial model with strong cognitive-behavioral and experiential components. General goals of the treatment are

Results

First, we wanted to identify what characterized patients' body attitudes when they present for treatment, and if any differences existed across the five different eating disorder subtypes. A MANOVA was conducted to compare the levels of the assessment scales between diagnostic groups at intake. Significant differences were found for negative appreciation of body size (BAT-1), (F(4, 193) = 9.274, p < .001) and the total BAT score (F(4, 193) = 4.401, p = .002). Also the five diagnostic groups differed

Discussion

The main purpose of the current study was to explore body experience (BE) as measured by the BAT in patients with different eating disorder subtypes and to determine whether the measured body experience changed over time while patients were in intensive outpatient day treatment. Consistent with the literature, our patient diagnositic subtype groups differed in BMI at intake. Following treatment both the AN subtypes indicate significant increases in BMI, while the BN subtypes and the EDNOS group

Dr. Cecile C. Exterkate, De Gelderse Roos, Wolfheze 2, 6874 BE Wolfheze and Nijmegen Institute for Scientist-Practitioners in Addiction, University of Nijmegen, The Netherlands.

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  • Cited by (0)

    Dr. Cecile C. Exterkate, De Gelderse Roos, Wolfheze 2, 6874 BE Wolfheze and Nijmegen Institute for Scientist-Practitioners in Addiction, University of Nijmegen, The Netherlands.

    Dr. Patricia F. Vriesendorp, Amarum, Specialist Center for Eating Disorders, GGNet, Zutphen, The Netherlands.

    Prof. Dr. Cor A.J. de Jong, Nijmegen Institute for Scientist-Practitioners in Addiction, University of Nijmegen, The Netherlands.

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